SlideShare a Scribd company logo
1 of 23
Download to read offline
MEDIASTINUM
BY:
PHANINDRA PRASAD POUDEL
ASSISTANT PROFESSOR
DEPARTMENT OF ANATOMY
DEFINATION
• Space between rt & lt
lungs & pleural sacs
• Extension:
Thoracic inlet above
to diaphragm below
Sternum anteriorly to
thoracic vertebrae
behind
BOUNDARIES
• Anteriorly: posterior
surface of sternum
• Posteriorly: anterior
surface of bodies of 12
thoracic vertebrae,
intervertebral disc,
anterior longitudinal
ligament
• Superior: thoracic inlet
• Inferior: upper surface of
diaphragm
• On each side: mediastinal
pleura of lungs
DIVISION
• Divided into superior
& inferior
mediastinum by an
imaginary plane
passing through the
sternal angle
(manubriosternal
joint) to the lower
border of 4th thoracic
vertebra.
SUPERIOR MEDIASTINUM
BOUNDARIES:
 Anterior: posterior surface of
manubrium sterni
 Posterior: anterior surface of
bodies of T1-T4 vertebrae,
intervertebral disc, anterior
longitudinal ligament
 Superior: thoracic inlet
 Inferior: horizontal plane
extending from sternal angle
(manubriosternal joint) to the
lower border of T4
 On each side: mediastinal
pleura and lungs
CONTENTS
• Arranged into 3 groups
a. Retrosternal:
 Origin of
sternothyroid &
sternohyoid
muscles
 Thymus gland
 Rt & lt
brachiocephalic
veins, Superior
vena cava, Left
superior
intercostal vein
CONTENTS…
b. Intermediate
structures:
Arch of aorta with
its 3 large
branches;
brachiocephalic
trunk, left common
carotid & left
subclavian arteries
Phrenic nerves,
vagus nerves &
cardiac nerves
CONTENTS…
c. Prevertebral
structures:
 Trachea with
paratracheal &
tracheosophageal
lymph nodes
 Esophagus
 Left recurrent
laryngeal nerve
 Thoracic duct
 Origin of longus colli
from T3
CLINICAL ANATOMY:
• Prevertebral fascia of neck:
 Extends into superior mediastinum & attached to T4
 Infection in neck may extend into superior mediastinum
• Pretracheal fascia of neck:
 Extends upto superior mediastinum & attached to the
tunica adventitia of arch of aorta
 Infection in between the pretracheal & prevertebral
fascia extends into superior mediastinum
 Results into infection in the superior mediastinum,
mediastinitis
II CLASS
INFERIOR MEDIASTINUM
BOUNDARIES:
 Anterior: posterior surface of
the body of sternum
 Posterior: anterior surface of
the bodies of T4-T12
vertebrae, intervertebral disc,
anterior longitudinal ligament
 Superior: horizontal plane
extending from sternal angle
(manubriosternal joint) to the
lower border of T4
 Inferior: diaphragm
 On each side: mediastinal
pleura and lungs
DIVISION OF THE INFERIOR MEDIASTINUM
INFERIOR MEDIASTINUM:
Divided by
pericardium into:
Anterior
mediastinum
Middle mediastinum
Posterior
mediastinum
ANTERIOR MEDIASTINUM
BOUNDARIES:
 Anterior : posterior
surface of body of
sternum
 Posterior : fibrous
pericardium
 Superior : transthoracic
plane
 Inferior : diaphragm
 On each side :
mediastinal pleura and
lungs
CONTENTS OF ANTERIOR
MEDIASTINUM
• Superior & inferior
sternopericardial
ligaments
• Loose aerolar
tissue
• Retrosternal lymph
nodes
• Mediastinal
branches of
internal thoracic
artery
MIDDLE MEDIASTINUM
BOUNDARIES:
Widest
subdivision
Occupies within
the fibrous
pericardium
Bounded on
each side by
mediastinal
pleura and lungs
CONTENTS OF MIDDLE MEDIASTINUM
 Pericardium enclosing heart
 Ascending aorta
 Pulmonary trunk with its rt &
lt branches
 Four pulmonary veins
 Lower half of SVC
 Arch of azygos vein
 Bifurcation of trachea- rt & lt
bronchi
 Deep cardiac plexus,
phrenic nerves,
pericardiophrenic vessels,
inferior tracheobronchial
lymph nodes
POSTERIOR MEDIASTINUM
BOUNDARIES:
 Anterior : above
downwards
 Bifurcation of trachea
 Pulmonary vessels
 Fibrous pericardium
 Posterior sloping surface of
diaphragm
 Posterior : bodies of
lower 8 thoracic
vertebrae, intervertebral
discs, anterior
longitudinal ligament
POSTERIOR MEDIASTINUM
Superior :
imaginary
horizontal plane
Inferior :
diaphragm
On each side :
mediastinal
pleura and lungs
CONTENTS OF POSTERIOR MEDIASTINUM
 Oesophagus
 Descending aorta &
its branches
 Azygos, hemiazygos
& accessory
hemiazygos veins
 Thoracic duct
 Vagus nerves,
splanchnic nerves
 Posterior mediastinal
lymph nodes
CLINICAL ANATOMY
a. Connection of posterior mediastinum with the
spaces around the neck via superior mediastinum
o Connection with retropharyngeal space, space
between trachea & esophagus, spaces around carotid
sheath of neck
o Infections of neck may gravitate into superior &
posterior mediastinum
b. Compression of mediastinal structures by
any form of tumours results into mediastinal
syndrome with various symptoms:
i. Obstruction of superior venacava gives rise to
engorgement of veins of upper half of the body
ii. Pressure over the trachea causes dyspnea &
cough
iii. Pressure over the esophagus causes dysphagia
iv. Pressure over the left recurrent laryngeal nerve
causes hoarseness of voice
v. Pressure over the intercostal nerve results into
intercostal neuralgia
vi. Pressure over the vertebral column causes the erosion
of vertebral bodies
vii. Pressure over the phrenic nerve causes the paralysis
of diaphragm
HOME ASSIGNMENT
1. Draw a well labeled diagram showing
the subdivisions of Mediastinum.
2. What are the boundaries and contents
of Inferior mediastinum?
THE END

More Related Content

Similar to 4.Mediastinum.pdf

Chest Cavity
Chest CavityChest Cavity
Chest Cavity
msu
 
269034 mediastinum
269034 mediastinum269034 mediastinum
269034 mediastinum
YoAmoNYC
 
269034 mediastinum
269034 mediastinum269034 mediastinum
269034 mediastinum
abctutor
 

Similar to 4.Mediastinum.pdf (20)

Mediastinum & pleurae
Mediastinum & pleurae Mediastinum & pleurae
Mediastinum & pleurae
 
Chest Cavity
Chest CavityChest Cavity
Chest Cavity
 
Basic anatomy of lung .ppt
Basic anatomy of lung  .pptBasic anatomy of lung  .ppt
Basic anatomy of lung .ppt
 
Thorax anatomy presentation
Thorax anatomy presentationThorax anatomy presentation
Thorax anatomy presentation
 
Mediastinal tumors
Mediastinal tumorsMediastinal tumors
Mediastinal tumors
 
Mediastinum.pptx
Mediastinum.pptxMediastinum.pptx
Mediastinum.pptx
 
MEDIASTINUM TUMOUR.pptx
MEDIASTINUM TUMOUR.pptxMEDIASTINUM TUMOUR.pptx
MEDIASTINUM TUMOUR.pptx
 
Mediastinum
MediastinumMediastinum
Mediastinum
 
269034 mediastinum
269034 mediastinum269034 mediastinum
269034 mediastinum
 
269034 mediastinum
269034 mediastinum269034 mediastinum
269034 mediastinum
 
Pleura and lung
Pleura and lungPleura and lung
Pleura and lung
 
mediastinal imaging and masses
mediastinal imaging and massesmediastinal imaging and masses
mediastinal imaging and masses
 
Thyroid cancer approach
Thyroid cancer approachThyroid cancer approach
Thyroid cancer approach
 
pleura of lungs.pptx
pleura of lungs.pptxpleura of lungs.pptx
pleura of lungs.pptx
 
Systemic examination of respiratory system
Systemic examination of respiratory systemSystemic examination of respiratory system
Systemic examination of respiratory system
 
Basic Radiology
Basic RadiologyBasic Radiology
Basic Radiology
 
RADIOLOGICAL ANATOMY OF THE MEDIASTINUM.PDF
RADIOLOGICAL ANATOMY OF THE MEDIASTINUM.PDFRADIOLOGICAL ANATOMY OF THE MEDIASTINUM.PDF
RADIOLOGICAL ANATOMY OF THE MEDIASTINUM.PDF
 
Mediastinum
MediastinumMediastinum
Mediastinum
 
BASIC RADIOLOGY
BASIC RADIOLOGYBASIC RADIOLOGY
BASIC RADIOLOGY
 
Lymphatic drainage of head and neck
Lymphatic drainage of head and neckLymphatic drainage of head and neck
Lymphatic drainage of head and neck
 

Recently uploaded

會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文
會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文
會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文
中 央社
 
SURVEY I created for uni project research
SURVEY I created for uni project researchSURVEY I created for uni project research
SURVEY I created for uni project research
CaitlinCummins3
 
Spellings Wk 4 and Wk 5 for Grade 4 at CAPS
Spellings Wk 4 and Wk 5 for Grade 4 at CAPSSpellings Wk 4 and Wk 5 for Grade 4 at CAPS
Spellings Wk 4 and Wk 5 for Grade 4 at CAPS
AnaAcapella
 

Recently uploaded (20)

OS-operating systems- ch05 (CPU Scheduling) ...
OS-operating systems- ch05 (CPU Scheduling) ...OS-operating systems- ch05 (CPU Scheduling) ...
OS-operating systems- ch05 (CPU Scheduling) ...
 
24 ĐỀ THAM KHẢO KÌ THI TUYỂN SINH VÀO LỚP 10 MÔN TIẾNG ANH SỞ GIÁO DỤC HẢI DƯ...
24 ĐỀ THAM KHẢO KÌ THI TUYỂN SINH VÀO LỚP 10 MÔN TIẾNG ANH SỞ GIÁO DỤC HẢI DƯ...24 ĐỀ THAM KHẢO KÌ THI TUYỂN SINH VÀO LỚP 10 MÔN TIẾNG ANH SỞ GIÁO DỤC HẢI DƯ...
24 ĐỀ THAM KHẢO KÌ THI TUYỂN SINH VÀO LỚP 10 MÔN TIẾNG ANH SỞ GIÁO DỤC HẢI DƯ...
 
male presentation...pdf.................
male presentation...pdf.................male presentation...pdf.................
male presentation...pdf.................
 
會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文
會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文
會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文會考英文
 
The Story of Village Palampur Class 9 Free Study Material PDF
The Story of Village Palampur Class 9 Free Study Material PDFThe Story of Village Palampur Class 9 Free Study Material PDF
The Story of Village Palampur Class 9 Free Study Material PDF
 
Basic Civil Engineering notes on Transportation Engineering & Modes of Transport
Basic Civil Engineering notes on Transportation Engineering & Modes of TransportBasic Civil Engineering notes on Transportation Engineering & Modes of Transport
Basic Civil Engineering notes on Transportation Engineering & Modes of Transport
 
Đề tieng anh thpt 2024 danh cho cac ban hoc sinh
Đề tieng anh thpt 2024 danh cho cac ban hoc sinhĐề tieng anh thpt 2024 danh cho cac ban hoc sinh
Đề tieng anh thpt 2024 danh cho cac ban hoc sinh
 
How to Manage Website in Odoo 17 Studio App.pptx
How to Manage Website in Odoo 17 Studio App.pptxHow to Manage Website in Odoo 17 Studio App.pptx
How to Manage Website in Odoo 17 Studio App.pptx
 
When Quality Assurance Meets Innovation in Higher Education - Report launch w...
When Quality Assurance Meets Innovation in Higher Education - Report launch w...When Quality Assurance Meets Innovation in Higher Education - Report launch w...
When Quality Assurance Meets Innovation in Higher Education - Report launch w...
 
SURVEY I created for uni project research
SURVEY I created for uni project researchSURVEY I created for uni project research
SURVEY I created for uni project research
 
An Overview of the Odoo 17 Knowledge App
An Overview of the Odoo 17 Knowledge AppAn Overview of the Odoo 17 Knowledge App
An Overview of the Odoo 17 Knowledge App
 
Sternal Fractures & Dislocations - EMGuidewire Radiology Reading Room
Sternal Fractures & Dislocations - EMGuidewire Radiology Reading RoomSternal Fractures & Dislocations - EMGuidewire Radiology Reading Room
Sternal Fractures & Dislocations - EMGuidewire Radiology Reading Room
 
e-Sealing at EADTU by Kamakshi Rajagopal
e-Sealing at EADTU by Kamakshi Rajagopale-Sealing at EADTU by Kamakshi Rajagopal
e-Sealing at EADTU by Kamakshi Rajagopal
 
Mattingly "AI & Prompt Design: Named Entity Recognition"
Mattingly "AI & Prompt Design: Named Entity Recognition"Mattingly "AI & Prompt Design: Named Entity Recognition"
Mattingly "AI & Prompt Design: Named Entity Recognition"
 
Supporting Newcomer Multilingual Learners
Supporting Newcomer  Multilingual LearnersSupporting Newcomer  Multilingual Learners
Supporting Newcomer Multilingual Learners
 
OSCM Unit 2_Operations Processes & Systems
OSCM Unit 2_Operations Processes & SystemsOSCM Unit 2_Operations Processes & Systems
OSCM Unit 2_Operations Processes & Systems
 
Observing-Correct-Grammar-in-Making-Definitions.pptx
Observing-Correct-Grammar-in-Making-Definitions.pptxObserving-Correct-Grammar-in-Making-Definitions.pptx
Observing-Correct-Grammar-in-Making-Definitions.pptx
 
Improved Approval Flow in Odoo 17 Studio App
Improved Approval Flow in Odoo 17 Studio AppImproved Approval Flow in Odoo 17 Studio App
Improved Approval Flow in Odoo 17 Studio App
 
Spellings Wk 4 and Wk 5 for Grade 4 at CAPS
Spellings Wk 4 and Wk 5 for Grade 4 at CAPSSpellings Wk 4 and Wk 5 for Grade 4 at CAPS
Spellings Wk 4 and Wk 5 for Grade 4 at CAPS
 
ĐỀ THAM KHẢO KÌ THI TUYỂN SINH VÀO LỚP 10 MÔN TIẾNG ANH FORM 50 CÂU TRẮC NGHI...
ĐỀ THAM KHẢO KÌ THI TUYỂN SINH VÀO LỚP 10 MÔN TIẾNG ANH FORM 50 CÂU TRẮC NGHI...ĐỀ THAM KHẢO KÌ THI TUYỂN SINH VÀO LỚP 10 MÔN TIẾNG ANH FORM 50 CÂU TRẮC NGHI...
ĐỀ THAM KHẢO KÌ THI TUYỂN SINH VÀO LỚP 10 MÔN TIẾNG ANH FORM 50 CÂU TRẮC NGHI...
 

4.Mediastinum.pdf

  • 1. MEDIASTINUM BY: PHANINDRA PRASAD POUDEL ASSISTANT PROFESSOR DEPARTMENT OF ANATOMY
  • 2. DEFINATION • Space between rt & lt lungs & pleural sacs • Extension: Thoracic inlet above to diaphragm below Sternum anteriorly to thoracic vertebrae behind
  • 3. BOUNDARIES • Anteriorly: posterior surface of sternum • Posteriorly: anterior surface of bodies of 12 thoracic vertebrae, intervertebral disc, anterior longitudinal ligament • Superior: thoracic inlet • Inferior: upper surface of diaphragm • On each side: mediastinal pleura of lungs
  • 4. DIVISION • Divided into superior & inferior mediastinum by an imaginary plane passing through the sternal angle (manubriosternal joint) to the lower border of 4th thoracic vertebra.
  • 5. SUPERIOR MEDIASTINUM BOUNDARIES:  Anterior: posterior surface of manubrium sterni  Posterior: anterior surface of bodies of T1-T4 vertebrae, intervertebral disc, anterior longitudinal ligament  Superior: thoracic inlet  Inferior: horizontal plane extending from sternal angle (manubriosternal joint) to the lower border of T4  On each side: mediastinal pleura and lungs
  • 6. CONTENTS • Arranged into 3 groups a. Retrosternal:  Origin of sternothyroid & sternohyoid muscles  Thymus gland  Rt & lt brachiocephalic veins, Superior vena cava, Left superior intercostal vein
  • 7. CONTENTS… b. Intermediate structures: Arch of aorta with its 3 large branches; brachiocephalic trunk, left common carotid & left subclavian arteries Phrenic nerves, vagus nerves & cardiac nerves
  • 8. CONTENTS… c. Prevertebral structures:  Trachea with paratracheal & tracheosophageal lymph nodes  Esophagus  Left recurrent laryngeal nerve  Thoracic duct  Origin of longus colli from T3
  • 9. CLINICAL ANATOMY: • Prevertebral fascia of neck:  Extends into superior mediastinum & attached to T4  Infection in neck may extend into superior mediastinum • Pretracheal fascia of neck:  Extends upto superior mediastinum & attached to the tunica adventitia of arch of aorta  Infection in between the pretracheal & prevertebral fascia extends into superior mediastinum  Results into infection in the superior mediastinum, mediastinitis
  • 11. INFERIOR MEDIASTINUM BOUNDARIES:  Anterior: posterior surface of the body of sternum  Posterior: anterior surface of the bodies of T4-T12 vertebrae, intervertebral disc, anterior longitudinal ligament  Superior: horizontal plane extending from sternal angle (manubriosternal joint) to the lower border of T4  Inferior: diaphragm  On each side: mediastinal pleura and lungs
  • 12. DIVISION OF THE INFERIOR MEDIASTINUM INFERIOR MEDIASTINUM: Divided by pericardium into: Anterior mediastinum Middle mediastinum Posterior mediastinum
  • 13. ANTERIOR MEDIASTINUM BOUNDARIES:  Anterior : posterior surface of body of sternum  Posterior : fibrous pericardium  Superior : transthoracic plane  Inferior : diaphragm  On each side : mediastinal pleura and lungs
  • 14. CONTENTS OF ANTERIOR MEDIASTINUM • Superior & inferior sternopericardial ligaments • Loose aerolar tissue • Retrosternal lymph nodes • Mediastinal branches of internal thoracic artery
  • 15. MIDDLE MEDIASTINUM BOUNDARIES: Widest subdivision Occupies within the fibrous pericardium Bounded on each side by mediastinal pleura and lungs
  • 16. CONTENTS OF MIDDLE MEDIASTINUM  Pericardium enclosing heart  Ascending aorta  Pulmonary trunk with its rt & lt branches  Four pulmonary veins  Lower half of SVC  Arch of azygos vein  Bifurcation of trachea- rt & lt bronchi  Deep cardiac plexus, phrenic nerves, pericardiophrenic vessels, inferior tracheobronchial lymph nodes
  • 17. POSTERIOR MEDIASTINUM BOUNDARIES:  Anterior : above downwards  Bifurcation of trachea  Pulmonary vessels  Fibrous pericardium  Posterior sloping surface of diaphragm  Posterior : bodies of lower 8 thoracic vertebrae, intervertebral discs, anterior longitudinal ligament
  • 18. POSTERIOR MEDIASTINUM Superior : imaginary horizontal plane Inferior : diaphragm On each side : mediastinal pleura and lungs
  • 19. CONTENTS OF POSTERIOR MEDIASTINUM  Oesophagus  Descending aorta & its branches  Azygos, hemiazygos & accessory hemiazygos veins  Thoracic duct  Vagus nerves, splanchnic nerves  Posterior mediastinal lymph nodes
  • 20. CLINICAL ANATOMY a. Connection of posterior mediastinum with the spaces around the neck via superior mediastinum o Connection with retropharyngeal space, space between trachea & esophagus, spaces around carotid sheath of neck o Infections of neck may gravitate into superior & posterior mediastinum
  • 21. b. Compression of mediastinal structures by any form of tumours results into mediastinal syndrome with various symptoms: i. Obstruction of superior venacava gives rise to engorgement of veins of upper half of the body ii. Pressure over the trachea causes dyspnea & cough iii. Pressure over the esophagus causes dysphagia
  • 22. iv. Pressure over the left recurrent laryngeal nerve causes hoarseness of voice v. Pressure over the intercostal nerve results into intercostal neuralgia vi. Pressure over the vertebral column causes the erosion of vertebral bodies vii. Pressure over the phrenic nerve causes the paralysis of diaphragm
  • 23. HOME ASSIGNMENT 1. Draw a well labeled diagram showing the subdivisions of Mediastinum. 2. What are the boundaries and contents of Inferior mediastinum? THE END